


Ectopia Cordis

by cs6ice



Category: Frozen (Disney Movies)
Genre: And if the medicine was more in touch with reality, F/F, Grey’s Anatomy-ish AU set in a fictional universe, No pandemic (I don’t think it’s right to exploit that for fiction at this point), Written for Frozen's seventh anniversary
Language: English
Status: Completed
Published: 2020-11-27
Updated: 2020-11-27
Packaged: 2021-03-10 00:46:50
Rating: Not Rated
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 8,334
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/27745447
Author URL: https://archiveofourown.org/users/cs6ice/pseuds/cs6ice
Summary: But there are times when she would lie awake and wonder how a heart can hurt and ache like this, and still continue beating as though it wasn’t broken.
Relationships: Anna/Elsa (Disney)
Comments: 23
Kudos: 72





	Ectopia Cordis

**Author's Note:**

> For Elsa, and as always, for Elsanna

She is seven months out of medical school and six months into her intern year when she is posted to St Olaf’s Medical Centre. More specifically, ‘the second floor’, a.k.a the neonatal unit, a.a.k.a the land of the tiny humans. The morning is sucked up by the black hole of admin work, but she now has her identification and access card, her beeper, and her EMR username and password. All that’s left is to pick up her scrubs from laundry services on the ground floor.

“I hate hospitals. Only sick people come here.” Huffs the petulant preschooler that she is sharing a lift with.

“Don’t shush me, that’s rude!” He scowls at the woman next to him, who is spotting a prominent baby bump.

The universal belief that hospitals are only for sick people isn’t always true, and this is one of the rare instances. The only thing that pregnant moms-to-be are sick of is having any semblance of peace and quiet in their lives for the next decade or two. Though it has to be said that growing a human isn’t without its own hazards, like trying not to puke your guts out, the risk of deep vein thrombosis, the aptly named HELLP syndrome, or the backaches from being gravid with seven pounds of fetus.

The kid turns to her, and _gawks_. “Mom!” He tugs on the woman’s arm. “It’s the princess from the movie!”

Elsa tries to muster a smile. It’s not in the job description, and she’s in neither coat nor scrubs, but she figures she ought to do her part to show the young and impressionable ones that hospitals aren’t always a scary and awful place. A pity that all she manages is an awkward half-smile that probably came out as a grimace.

The kid continues to stare, while she takes to fiddling with her braid – woven in the same side-French-over-the-shoulder style as the ‘princess from the movie’ – all while cursing her alabaster skin that makes it impossible to hide a blush, as well as her celebrity, no, _Disney_ doppelganger.

.

She begins most of her days on nursery duty. A newborn exam generally consists of checking for birth injuries, cleft palates, heart murmurs (yes the heart ‘murmurs’ sometimes, generally but not always a cause for concern, but mostly it just does that _lub-dub lub-dub_ thing), clicky hips, and waiting for the sleeping beauties to finally open their eyes for all of one second so she can look for a red reflex, before moving on to the next squiggly lump that kicks and wails.

Crying is a contagion, the most infective one there is. One starts off with a plaintive note, and suddenly the whole choir is chorusing a strident symphony. Think you know what it’s like to have your tympanic membranes assaulted? Try being in a small enclosed space with thirty screaming babies.

The squiggly lump in cot 13 is looking a little blue. She holds her stethoscope to its chest. There it is, the unmistakable sound of a heartbeat. And a murmur. She orders for a pulse-ox and blood pressure check, and calls for an urgent cardiology consult. While they wait for that, she is paged over to Special Care for another squiggly lump that needs some blood work done. 

“This will hurt a little.” She cautions gently as she sticks the tiny needle into the even tinier vein, while those tiny lungs continue to scream bloody murder. _This is ridiculous, why am I even talking to it?_

Still, it doesn’t stop her from muttering a couple of ‘I’m sorry-s’ as she sticks an oversized plaster onto the tiny fist.

It’s bad news when she gets back to the nursery. Cot 13 has a critical cyanotic heart defect, and has been booked for surgery tomorrow. She spends all fifteen minutes of lunch debating if she should stop by the N-ICU to check on how he’s doing, perhaps offer some words of encouragement, meaningless as they will be to a days-old infant.

In the end she decides against it. She’s done her job, and St Olaf’s has some of the best cardiac surgeons in the country, so 13 is definitely in good hands. But it’s still a high-risk surgery, and you never know what may happen.

Rule number one of this job – don’t get attached.

.

It was in her first-year anatomy prosection class, surrounded by the smell of formaldehyde and starchy lab coats, that she saw her first heart. No, first _hearts_. 

The first was the size of a football. ‘Cardiomegaly’ is the term used to describe a heart that is increased in size, and this one definitely fit the bill.

The next heart was smaller, about the size of a fist, but felt just as weighted in her palm, with thick hypertrophied walls – a heart on ‘roids, someone had quipped. The myocardium (myo – muscles, cardium – of the heart) is just like any other muscle in the body, the more it works the bigger it gets, meaning that this was either a very athletic heart or one that had been working overtime until it finally gave up the ghost.

More hearts followed, some healthy, most not, all carefully pre-dissected to reveal their inner secrets. The last heart that was passed around was small – _too small_ – no larger than the size of her thumb, but fully formed nevertheless, with the same chambers and valves and septum, and chord-like strands and muscular ridges running along its inner walls. Death in-utero or an elective abortion? All she knows is that this little one never had the chance to take its first breath, or to be held in a parent’s arms. A life ended before it even began.

But it was years before that she had first learnt what a heart looked it, from the posters on the walls of the waiting room in the Women’s Heart Centre, as she sat clutching her mother’s hand tight, as though the woman would disappear as soon as she let it go.

In her memories, Iduna always had a doting smile, and a bluish tinge to her lips. Her doctors hadn’t expected her to live beyond a decade, but she had survived two pregnancies and nurtured two girls into their teens.

She feels a sharp stab in her chest, forcibly turning off that faucet before more memories can spill out. But there are times when she would lie awake and wonder how a heart can hurt and ache like this, and still continue beating as though it wasn’t broken.

Her beeper chirps. It’s a page from the nursery. They want her to speak to a mother refusing routine newborn shots.

“We just want what’s best for your baby.” She tries to explain, only to have the worn-out-from-labour and in-no-mood-to-dispute-her-organic-birth-plan mother cut her short.

“I know what’s best for my child. Have you ever been a mother?”

Her first thought is yes. After all, she was once a surrogate maternal figure to a feisty teenage girl. She had wanted to be everything for Anna – mom, dad, cool older sibling, friend and confidante.

But in the end she had been nothing, having spent every spare hour working to make ends meet, while scraping funds for Anna’s college tuition and her own pre-med studies.

_Anna…_

There’s that little knife in her chest again.

.

She’s into her third week here when she runs into _her_.

“Psst, pretty blonde. Yea you with the gorgeous blue eyes. You got a minute?”

Elsa pauses in her harried strides down the corridor, turning to the speaker – ‘Anna Andersen’, her medical student ID reads – with a questioning blink, while her beeper continues its peremptory demands for her attention.

“May I be of assistance?”

 _Seriously, Winters? Who speaks like that in the twenty-first century? May as well bow and curtsy while you’re at it._ She chides herself.

Anna responds by grabbing hold of her hand and she barely manages to keep herself from startling like a newborn in its sleep at the warm shock that courses through her. And then she does for real when the girl pulls out a sterling silver ring and slips it onto her finger.

“I knew you would say yes!” Suddenly those sun-kissed freckles are right up in her face, soft lips brushing against her cheek to whisper in her ear. “Just play along, I’ll explain in a minute.”

And then she is tugging Elsa over to an elderly woman in a cotton frock gown, a saline bag hanging from an IV pole next to her wheelchair. “Look, Nana.” She holds up their joint hands. “She said yes!”

“Oh Gerda, I never thought I’d see this day! And my, isn’t she a fetching one!”

‘Gerda’ beams at her newfangled fiancée, looking a little too much to Elsa like the cat who ate the canary, or one that’s about to start kneading on her soon. But she plays along with the little ginger kitten, helping to escort her ‘Nana’ back to her room, and even promising to take good care of her ‘sweet little Gerda, who could at times be a real handful’.

Elsa doesn’t doubt that one bit. Her smile is a little too frozen, but she is spared from further pretence by the incessant beeping in her pocket.

Anna offers to walk her out. “Thanks, erm…I didn’t get your name?”

A pale eyebrow arches. “Should’ve asked that before you put a ring on it.”

The girl had the temerity to pout. “You happened to be passing by so…”

“So you thought you’d rope me into your little skit?” She crosses her arms over her chest. “What if the real ‘Gerda’ shows up, with no fiancée to speak of? Really Anna, you should’ve known better, you–”

She catches herself. She had no right to lecture this kid, just as she had no right to lecture…

“I know, I know. Look, she’s got end-stage Alzheimer’s, and this is the first time that she’s been lucid in months. Well, apart from thinking I’m her long-lost grand-daughter, that is. I just wanted to help fulfil her wish.”

Elsa really has to go, but she lets her gaze linger for a few seconds longer on the girl who shares both Anna’s name and her big and kind heart. Finally she sighs. “You shouldn’t get attached.”

Whatever response Anna has to say is interrupted by her phone choosing that exact moment to spew out a rather tacky ringtone. She catches a shred of the redhead’s side of the conversation. “Mom, I’m fine! I can’t believe you’re still freaking out every time I sneeze…yes I took my medications…”

Girl doesn’t know how fortunate she is to have parents to worry about her, she thinks to herself as she turns to leave.

It isn’t until she’s home later that night, seated at her bedside table practising square knots and vertical mattresses over a synthetic skin board with a needle holder and a hair-like thread called a suture, that she realises something is off. 

A glint of silver catches her eye.

That’s right, she still has the ring on.

.

The heart never stops working, have you ever thought about it? Once it stops, you’re dead. It makes her wonder why no one has ever coined the phrase ‘as hardworking as the heart’.

Or ‘as hardworking as a sleep-deprived intern on her tenth one-in-three call in a row’.

Tonight is one of _those_ nights. The labour ward is full, with a board of potentially high-risk deliveries, i.e. those requiring attendance by the neonatal team, as these newborns are likely to need some form of resuscitation at birth.

And of course she has to be the one carrying the first-on page.

Her first ‘standby’ is for a micro-premmie. Seven hundred grams is all she weighed. Elsa has never held a life that small and fragile in her hands before. The senior resident inserts a breathing tube while she listens to the newborn’s heart rate, reporting it at a reassuring hundred and fifty beats-per-minute. The ickle thing is carefully transferred to an incubator in the N-ICU, where she will spend her first night under a vigilant watch, serenaded by a myriad of humming and beeping monitors and devices, and the company of other too-tiny humans, all probably wishing that they were still snuggled in their waterbeds, listening to their mothers’ comforting heartbeats.

This one has a long fight ahead of it. She tells herself not to get attached. 

_Bzzz!_ Her phone buzzes with a new message. ‘Dinner’s in the call room! There’s meatball pizza for the whole team!’ Free food is always appreciated, if you actually get to eat it. A buzz again, it’s her beeper this time. ‘CRASH C-SEC in OR 9!’ 

Crash C-section. Dreaded words for anyone on a neonates call. The first response is usually crap – _yours_. And then you do the Olympic sprint down to the OR, pull on clean scrubs over your dirty ones, slip into any theatre clogs you can find – who cares if there are only two right – and pray the senior resident is right behind.

“Her water broke and the cord slipped out.” The midwife tells her as they hastily don gloves and caps and masks. “Heart rate dropped off for a minute, but its showing a good trace now.”

A cord prolapse happens when the umbilical cord drops through the open cervix ahead of the baby. It’s a rare obstetric emergency that can result in a lack of oxygen to the fetus and in the worst case fetal demise. Thankfully, this one comes out looking pink and vigorous, and wailing like a banshee.

She’s barely taken two steps out of the OR when she is beeped to the labour ward to standby for an impending delivery with ‘fetal distress’. The first thing she sees on entering the room is that the liquor (a fancy Latin word for water) is a dark murky brown, not stained but _slathered_ with meconium (or fetus poo in non-medical terms).

“She’s been pushing for three hours. If this baby doesn’t come out soon, we’ll be converting to an emergency C-section.” The OB resident fills her in while she checks her equipment for suction and intubation.

It’s telling that even a fetus’ first response to distress is to majorly crap itself. Unfortunately, if you crap into the waterbag that you’re floating in, all that crap-filled fluid is going to go straight into your lungs. The fetal heart monitor decels and so does her heart. The next minutes are tense but there’s nothing she can do until the slimey meconium-covered baby is finally extracted by ventouse (another fancy name for a suction cup attached to a vacuum hose). More of that thick viscous stuff is suctioned out of his airway and he cries his first breath, a misshapen head all he has to show for the ordeal.

“Don’t worry, it looks funny now but it’ll be back to normal in a few days.” She reassures the relieved parents.

It isn’t until 2am that she finally makes it back to the call room, guzzling down a bottle of water to resuscitate her poor kidneys. There’s one slice of meatball-less pizza and half a ring of calamari left. She saunters it in mayonnaise and ketchup and wolfs it down, making her way over to the nearest workstation to begin typing up her standby notes.

 _Feed, food, now!_ Her stomach whines, making sure to grumble its displeasure.

 _No caffeine, no work._ Even her brain is getting a little snippy with her.

The cafeteria is closed at this hour, and in the pantry she finds not a leftover bagel or at the very least a Luna bar, but a girl with hair hued in the colours of autumn’s falling leaves and fire-gold sunsets. Her heart skips a beat, before realising with a pang that it isn’t _Anna_ , not the one whose tiny hand she had held all those years ago, grasping it as tightly as she had grasped their mother’s; the one whom she had promised to look after forever, and then irrevocably broken that promise. 

Teal eyes glance up, registering surprise. “Mmphhggghh!” The strawberry blonde garbles around a mouthful of sandwich, her unintelligible spluttering quickly descending into a fit of choking gags and wheezy coughs.

“…are you in need of assistance?” Anna doesn’t respond and that’s Elsa’s cue to scramble to her side, wrap her arms around her waist from behind, and make an upward jabbing motion with her fists.

“Thank Heimlich!” Is the first thing the walking hazard says once she has recovered her faculties of speech. “Though it’s not quite what I had in mind when a beautiful girl is pressed up against me.”

She laughs out loud at Elsa’s scandalised look. “Sandwich? It’s peanut butter and jelly, with some salami and cheese, and whatever else I could find in my fridge.”

“I’ll pass.” Elsa’s stomach protests loudly and she blushes to the tip of her ears.

Anna looks like she has something to say but she makes sure to swallow her food bolus first this time. “Y’know, I didn’t get to say this before, but you remind me a lot of–”

Oh. _No._ Here it goes again.

“My goldfish!” The redhead holds up her phone, grinning like a proud parent whilst showing off a selfie of her and a pearly-white goldfish. “I’m not allowed to have any pets other than goldfishes, and she just looked so lonely and sad that I had to take her home. Plus I didn’t like how that orange tabby at the shop was eyeing her like she was a tasty snack.”

Elsa sweatdrops. _I remind her of that?_

.

“So umm, why medicine?”

The reply is instantaneous. “I’ve always followed my heart, and that’s what it wanted.”

Anna proceeds to ramble on about this being the first week of her O&G posting, but Elsa has already deduced that from the copy of _Hacker and Moore’s Essentials of Obstetrics and Gynaecology_ sitting on the table next to her, in mint condition apart from a splotch of peanut butter on the cover. 

What she doesn’t get is why the girl is still here, roughing it up with the rest of them. Students assigned to the night float aren’t expected to stay in past midnight. As soon as the clock strikes twelve, they’re out the door like Cinderella at the ball, no doubt eager to head home to spend some quality time with a textbook.

She poses the question.

“Just thought I’d stay to catch a couple more deliveries. You can’t tell these newborns that they’re only allowed to come out before midnight, right? And I’ve been helping to walk Mrs Robinson up and down the halls. Her husband’s catching the next flight in, but it’s been delayed because of that huge storm sweeping the coast. ‘Tis the season of rain and squall it seems…” She trails off with a sigh.

Elsa nods commiseratively while she hunts for a mug to make herself a coffee. There’s a prickling sensation at her back and sure enough, when she turns around, those bright and deceptively innocent eyes are boring holes into her.

“What?”

Anna is thinking, and that itself is enough to make the hairs on Elsa’s neck stand on end. Her brow is knitted, her nose scrunched, one finger tapping against her chin as she mutters to herself. “Definitely neuro. The face and the _hair_. She’s a total _McDreamy_. I wonder if she has a thing for ferryboats too?”

This isn’t the first time that someone has complimented her looks. But Anna’s gaze is like the sun scorching her cheeks. She just about manages to keep her cool, blushy ears non-withstanding. “I like snowboarding and crocheting. Never been on a ferryboat in my life.”

Her beeper goes off again, a reminder that she shouldn’t be fraternising on the job.

“So where did you match?” Anna manages to get in a final question. “I know the results came out last week!”

“Arendelle General…” Elsa is secretly thankful that she’s already half out the door. “… _neurosurgery_.”

It isn’t until she is all but passed-out on her bed at home that she realises she’s forgotten to return the ring. Again.

.

Another busy night, another premmie is brought in.

The initial delivery room resuscitation goes smoothly. But back in the N-ICU the baby isn’t breathing so well, so a plastic tube is inserted into his airway and connected to a ventilator, and a mucousy suspension of bovine lung extract – one vial of which probably costs more than her entire week’s paycheck – is administered to aid the expansion of his immature lungs.

An urgent call comes for a flat newborn in delivery, so they all run for that. Another is noted to be breathing hard, but settles within an hour.

“Delayed adaptation.” She explains to the parents. Change is hard, for some more so than others.

After that, she is beeped to Special Care to see a growing prem who is having a run of ‘As’ and ‘Bs’ (medical lingo for ‘apneas’ and ‘bradys’, which themselves mean a prolonged pause in a baby’s breathing that results in dropping of oxygen levels and heart rate). It can be a harbinger of anything, from bad lungs to a life-threatening infection or a dangerous inflammation of the intestines. But in this case everything checks out fine, and the only conclusion is that this little one is simply due for her nightly dose of caffeine.

 _You and me both, kid._ Elsa thinks as she traipses off in search of coffee and a quick nibble.

A whole half-hour passes without a peep from her beeper. Maybe her call luck is starting to look up, though it only leaves her with a mildly anxious feeling, like that premonitory sneezing before an awful cold.

Athohallan help her, is that who she thinks it is, waving an arm like she is trying her best to dislocate it.

“Hey, McCutie!”

Elsa bites back a groan. “What are you doing here, Anna? Shouldn’t you be out looking for kittens to rescue or something?”

She expects the girl to pout, but instead she is met with a Cheshire grin. “You’re a hard one to catch. I’ve been looking all over for you. Thought we could pop open a bottle.”

“Pop a bottle…? Why?” She casts a leery glance at the bottle of bubbly in the strawberry blonde’s hand, eyeing it with equal amounts of bafflement and distrust.

In contrast, there’s a crinkle of amusement in Anna’s eyes. “To toast our engagement, what else? No wait, I’m kidding! It’s to celebrate your residency match. I’m sure you’ve already done that, but once more wouldn’t hurt!”

Celebrate? Perhaps if Anna – _her Anna_ – was still here, they would have gone out for a fancy dinner at an upscale restaurant. Anna would have insisted and she could never say no to her. There might have been champagne, and cake, lots of cake. But now it just felt pointless and hollow. No success, no happiness, no celebration would mean anything without her by her side.

“I can’t, I’m on shift now. And it’s really not a big deal.” She tries to let her down easy, though she can’t help feeling like a puppy punter. But if there’s one thing she’s come to realise about this puppy, it’s that there’s no dissuading her when she’s set her heart on something.

“Relax, it’s just sparkling cider, see?” The bottle of faux-champagne is shoved in her face. “And of course it’s a big deal. It’s a once in a lifetime deal.”

“I really don’t–”

‘Pop!’ The cork flies off the bottle, but Elsa doesn’t hear it so much as _feels_ it.

You know how doctors are always asking you to rate your pain? From an ant bite to the worst pain of your life? This may not be the latter, but it damn near comes close.

“Oh god, your nose–” She hears Anna gasp.

“I–m fine.” She chokes out, vaguely aware of blood dribbling down the front of her blue cotton scrubs and onto the floor. It makes it a little difficult to breath. Without warning, the lights in her head go out, and when they flicker on again, she’s lying with her head pillowed in someone’s lap. Oddly enough, her first thought is–

“My beeper–did it–?”

“Hold still, don’t try to sit up! And no, it didn’t. You’ve been out for five minutes, tops.” An ice-filled kerchief is pressed to the bridge of her nose. “I don’t think it’s broken, but maybe we should get an X-ray just to be sure.”

She manages a nod. The pain is still dull and aching and throbbing, making her eyes water. “I’m not–crr–ying.”

Her indignant face only makes Anna laugh, though she hurriedly stifles it, looking like a guilty kitten that didn’t mean to destroy the sofa, if by sofa you mean Elsa’s dignity.

It takes a week for both her black eyes to go away and twice as long for Anna to stop apologising.

And she still needs to return that ring to her.

.

It’s October now, and the days are awash in a rich palette of autumn tones. Seeing them always makes her feel warm inside, even as the air turns crisp and the wind blows a little colder, a constant reminder of chillier months to come.

Today isn’t supposed to be one of _those_ days. Her rounds in the nursery are done early and she is assigned to cover the elective C-sections for the rest of the morning, normally the duty of the theatre midwives, but there’s been a nasty flu bug going around and half the staff’s out with it. 

Time of birth–10:21h. She fills that out on the charts along with the baby’s Apgar scores (a simple measure of a newborn’s well-being immediately after birth). Congratulations are offered to the parents, whose blissful smiles are hidden behind their facemasks but reflected in their eyes.

Her next case is a single mother-to-be. No husband or partner here to cut the cord. As someone who was once a pseudo single parent herself, Elsa can empathise with the terrified but brave face that the woman is putting on.

The baby comes out vigorous, but she doesn’t hear the hearty bawls that help expel fluid and expand the lungs. A quick round of drying and suctioning produces a few whimperish sounds, and she gives it a flick on the heel to encourage a good cry.

Instead she hears a cacophony of alarms going off from behind.

“Sats are dropping, she’s bradying down!”

“We’re bagging her up and getting ready to intubate her.”

“I’m not getting a pulse. Start CPR and call a code.”

The baby starts wailing. She swaddles her as best she can, picking the small bundle up and cradling her to her thumping chest.

“Shhh, it’ll be okay.” She hopes it will be, or she will have just told this little one the first lie of the thousands that await her for the rest of her life.

.

A day later, she pays a visit to the baby’s mother in the ICU.

The monitors are beeping evenly, registering stable numbers, but they don’t tell the whole story. Her gaze shifts to the two large cannulae – one bright red and the other a few shades darker – protruding from the patient’s neck, connected to a life support machine.

The cause of the sudden collapse has been determined to be an amniotic fluid embolism, an exceedingly rare and catastrophic complication of childbirth, according to the textbooks. And one that is completely unpreventable.

It’s scary isn’t it, how life can change in an instant. You can’t prepare yourself. You don’t even see it coming. It isn’t fair, but nothing ever is.

A week later, the patient has come off the heart pump machine but remains fully ventilated with no signs of life apart from a palpable pulse and an audible heartbeat. The heart has a great capacity for recovery, and can stay alive long after the brain is dead. Elsa knows this better than anyone, knows how difficult it is to accept, how difficult it is to let go.

Her phone vibrates with a message, reminding her to ask social services for an update on the temporary placement plans for the baby. It looks like those plans are going to be permanent, she sighs ruefully as she trudges back to the postnatal ward.

Neonates, the self-professed happiest unit on the floor. If only that were true. The happy ones go home. It’s the sick ones that stay, and the ones that have no home to go. Unplanned, unexpected, unwanted, unloved. This little one is an exception.

“You can carry her if you like.” A nurse tells her, those simple words sending her reeling to the past.

_“Would you like to carry her, Elsa?”_

_“Can I?” Iduna simply smiles and seats her on a chair, gently depositing the week old infant into her arms. It’s hard to believe that Anna was once so small and fragile, and holding her had felt like she was holding her own heart in her hands._

Another week later and it’s official. This little one is now, like her, an orphan. The social workers have come to pick her up. All they need is for her to sign off on the discharge papers.

“Hang in there little fighter.” She whispers to the sleeping child, who had, for two short weeks, filled a small piece of the hole in her heart that she thought could never be filled again.

.

“Hey…” How does Anna always manage to find her, even when she doesn’t want to be found?

“Anna?” She swipes at her cheeks. “What are you doing here?”

The girl takes a seat next to her on the stairs. “Oh, you know, just scouring the stairways, looking for lost kittens.”

For a minute they sit in silence, and then Anna snatches up her hand. “Come with me!”

They end up at Anna’s locker in the medical student lounge.

“Aren’t you a little old for trick or treat?” She shoots a squinty-eyed look at the odd-looking costume that the redhead has on, which has the shape of a rounded blob with out-jutting spikes. “What are you supposed to be anyway? Some kind of germ?”

“No, I’m a macrophage! I get rid of those nasty germs and alert the body of intruders!” The ‘immune cell’ puffs out its chest, brandishing a sign that says ‘Stop! Show ID!’ “The nurses are throwing a Halloween party for the kids in the paeds ward, and since you’re off tonight, I volunteered us to go hand out candy!”

“But I…don’t have a costume…” Plus she doesn’t want to ruin it for the kids by being all awkward and tongue-tied. _Anna_ had once said that she looked like a shy kitten trying to hide under its own tail when it came to parties and being social in general.

“Don’t worry, I’ve got just the thing!” Anna holds up a crystal-blue off-the-shoulder dress, with long translucent sleeves, and a glittery sheer cape woven with snowflakes. “Ta-da! And we won’t even need the wig.”

Elsa tries not to cringe as she is ushered into a changing room by a still-grinning Anna. The dress is a slight struggle to get into, probably because she hasn’t worn anything but scrubs in over six months. Taking a deep breath, she slides the door open.

“Wow. Elsa. You look…”

 _Utterly ridiculous?_ She gives the goggling girl an icy glare, daring her to laugh. Honestly, she doesn’t know why she’s even doing this for her. Maybe it’s because her name is Anna, and she could never deny Anna anything.

“Absolutely gorgeous.” Anna beams like a little sun. “It brings out your eyes.”

There’s more people at the party than she expected, and they all seem to know Anna. She tries her best to follow the younger girl’s lead, and seeing so many happy faces smiling up at her does ease her qualms about this being a terrible idea. But at the same time she can’t help fiddling with her braid and nervously wringing her glove-clad hands.

“You’re doing great, completely in character!” Anna assures her, before tottering off to get them some pumpkin juice.

Elsa retreats to a corner, feeling a little lost without her. She hears the sound of footsteps, too soft and uncertain to be Anna’s, and sure enough, when she turns around, there’s a little girl in a crocheted beanie approaching her shyly. She stoops down, smiling shyly back. 

‘Hope’ proudly tells her that she is seven years old – eight in two months, and that Princess Ellia is her favourite Disney princess.

“I am?” She just about remembers to stay in character, cheeks pinking a little, even though the girl’s adoring look isn’t actually for her, but for the persona she is playing. 

Hope bobs her head earnestly. “You’re always trying so hard to be brave and strong, even when you’re lonely and sad. I want to be brave like you too.”

Elsa bites her lip. Her vision blurs and for a moment the white walls fade, replaced by a weedy sidewalk, and a little girl with a light dusting of freckles on a tear-streaked face, cradling her broken arm to her chest as she tries to explain to a frantic Elsa how she had taken a tumble off her bicycle. _“Don’t move Anna, I’ll call mom. We have to get you to the hospital. I know it hurts, but can you be brave for me?”_

She looks up into eyes that are wise beyond their years, and wonders when this child has learnt to hide her pain. “You don’t have to be brave all the time.”

The smile slips off the girl’s face. “The needles and the chemo, they hurt a lot, but not as much as when I see my mom crying. I want to get better, so she won’t have to be sad anymore.”

The words are humbling both in their maturity and innocence, and for some inexplicable reason they remind her of a different Anna, whose smile she catches from across the room. She hopes that neither of them will ever have to learn that life isn’t a fairy-tale, and that not enough stories get their happy endings.

“Will you come visit me again?” Hope asks when her mother comes to take her back to her room.

Elsa nods, wishing she can do more for her. But it makes Hope’s face light up, and for now that’s good enough.

.

There is a waning crescent moon glowing placidly down on them as she pulls into Anna’s driveway.

“Thanks for the ride. And for tonight. You were great with the kids.” Anna’s smile is tired but happy, and it’s a little funny seeing this bright-eyed-and-bushy-tailed-beaver looking like a sleepy-kitten-that’s-due-for-its-nap for once.

She clears her throat. “I, erm, had a good time too. We should do this again.”

“Sounds like a date.”

No matter how much coolness she puts into her expression, she can’t hide the delicate flush that suffuses her cheeks. She resorts to stuffing her hands into her pockets as she walks the uncontrite instigator to the door. Their eyes meet again and Elsa hurriedly averts her gaze. “I should go, I err, I wish you a good night, Anna.”

She nearly jumps out of her skin when Anna’s fingers close around her wrist. Her hands are so warm while Elsa’s are so cold. And the way she is looking at her makes the fragments of her heart feel whole again, if only for a second. But it isn’t fair to Anna, isn’t fair that Elsa’s heart is a cold locked door, isn’t fair that when she looks at her, all she can see is…

“Anna!” The front door bursts open and a woman all but rushes out, throwing her arms around the younger girl. “You’re back! Your father and I have been waiting for you. We’ve got your favourite chocolate mousse cake from Oaken’s.”

“Mo–om, I told you I didn’t want a celebration.”

“But it’s your twenty-first birthday! You’re officially a young adult now! We just thought, given everything you’ve been through, that–”

“It’s your birthday?”

The woman turns to her and looks taken aback for a second, before Anna helpfully intervenes. “Elsa’s an intern at the hospital I’m at.”

“And yes, it’s my birthday today, which means you have to come in and share my cake with me.”

Elsa is happy to, of course. In contrast, it’s Anna who looks uncharacteristically subdued as the traditional birthday jingle is sung and it comes time to blow out the candles.

“Wait, you should make a wish first.” Anna blanches at her words, visibly deflating like a leaking balloon. And just like that she’s ruined the mood of the evening. The rich chocolaty cake taste like ash in her mouth. Even the moon seems to reflect her feelings of confusion as Anna sees her out to her car. And the softly flickering starlight only magnifies the gloominess of the murky night sky.

As they reach the white sedan, the strawberry blonde snags a hand out, grabbing hold of Elsa’s. “Six years ago I made a wish on my birthday…and it came true. Since then I swore I’ll never wish for anything else again.”

Pale moonlight gently caresses her face, and for a split second Elsa feels implored to do the same.

Anna’s voice hides a pain that she doesn’t understand, but it’s clear that it’s taking every ounce of her courage to tell her this, so she simply nods and confides a secret of her own. “I’ve never told you this before, but you remind me of someone. My sister. She would have been twenty-one too if she hadn’t been in an accident. If she were here, I think she would’ve loved to meet you.”

.

Day 258 of life as a zombie.

She is back on the surgical rotation for the final three months of her intern year, in the land of the big people, though big babies may be more appropriate for some. There’s nothing worse than screaming babies, until you’ve met screaming adults.

The elevator ‘dings’ open and she hurries out, beginning the morning routine of checking on the post-ops. Today she’s running a little behind on the clock, courtesy of spilling iced-coffee on her scrubs and having to grab a fresh set from her locker. Though there are others who are having a considerably worse morning than her.

Bed 9, “35-year-old male, post-op day 1 from a patch repair of a perforated gastric ulcer”, is practically rolling in bed with pain. It doesn’t take a neurosurgeon to figure out that he has a kinked Foley’s catheter which has given him a 28-week-pregnant bladder. If only all problems are so easily solved. Over in the next room, she meets bed 11, “25-year-old male, status-post exploratory laparotomy after intentionally swallowing his girlfriend's car keys. Just wheeled in from recovery, still a little loopy.” The Romeo gets pain meds and IV fluids prescribed, but the hole in his heart is going to be a little harder to fix than the one in his gut. He refuses to let her leave until she promises to call his girlfriend to tell her how sorry he is.

It goes on for another thirty patients more. Then the senior residents and attendings arrive, and everyone bustles around in a whirlwind of daily plans and orders. Once that is done, the troop whisks off to the OR, leaving the interns to their scut work.

At half-past-noon she decides that she better get some grub if she doesn’t want to end up with a hole in her stomach too. But first she has a call to make.

“…he wants to tell you that…” She glances at the scrap of paper in her hand, and the barely legible chicken scrawl on it. “‘I’m so sorry. Please take me back. Life without you would be like a broken pencil–’”

“Tell him that if he wants to apologise, he should at least call me himself.” _Beeeeeeeep_.

“Point.” She makes a mental note to remind the nurses to keep all sharp and pointy objects away from Romeo for now.

“Don’t you mean ‘pointless’?”

“Anna!” She nearly drops the phone in surprise. “What are you doing here?”

“I heard there was a cute doctor on this floor, and I was wondering if she would like to have lunch with me?” A grin and a wink. It’s clear that the redhead is back to being her usual sundrenched self.

Elsa rolls her eyes, but she feels the corners of her lips tugging into a smile. “Seriously Anna, why are you here? Aren’t you on study break this week?”

She gets a mumbled response about a medical check-up, as Anna leads her toward the elevators. “What shall we eat? My head says salad, but my heart says tacos!”

Of course they end up in line for tacos. “Do you always listen to what your heart tells you?”

Anna nods firmly. “Every time.”

.

November 27th. The date is marked out on her calendar. She had planned to take this day off, to huddle in bed and close her eyes and wish herself back to the past. It’s a bargain she’s made with her heart – if it will do its best to be strong and brave then on one day every year she will let it be weak. 

She wakes to the shrill ringing of her phone. For a second her blood runs cold, and then her mind catches up to the present. There’s been a mass trauma event and the hospital is on standby. They’ll need her in as soon as she can, to help the trauma team in Emergency.

The ER is a sea of organised chaos. The walking wounded make up the largest group. Thankfully most have only minor injuries – lacerations that need suturing, fractures that need to be set and cast. In the trauma bay, she’s assisting in a resuscitation of a blunt abdo trauma who has just loss his radial pulse. Someone is calling for more O-neg blood, while the rest of them prepare to take him up to surgery.

She’s just gotten done with that and hot-footing it back to the ER when she spots a familiar face in the crowd.

“Mrs Andersen?” Anna’s fleeting mention of a medical check-up springs to the forefront of her mind and like every doctor, even one that is not yet a year out of medical school, she’s been conditioned to assume the worst. “Is everything okay? Is it Anna? Has she been admitted?”

Mrs Andersen reassures her that Anna is fine. The reason she’s here is for ‘a bunch of routine annual tests for her heart condition’.

 _Heart condition?_ Somehow she doesn’t feel all that relieved, but she manages to finish up the rest of her sutures and sign out her undischarged patients to the oncoming shift before heading up to the cardiology ward on the ninth floor.

Handovers are ongoing at the counter when she walks by. “…bed 19, Anna Andersen. In for endomyocardial biopsy, first case tomorrow. The new intern’s in there starting her IV.”

Biopsy? Why would–? She frowns, before knocking and letting herself into the room.

“Elsa?!” Teal eyes widen, lighting up like a kid at Christmas. “How did you – ouch!” She leans her head back as a needle is jabbed into her arm, clearly used to being a human pincushion.

“Here, let me try.” Elsa offers, after another fifteen minutes of watching the nervous intern’s struggles with the IV.

“It’s not her fault.” Anna’s tone is apologetic. “I’ve got bad veins.”

And a high pain tolerance, Elsa notes as she studies the slender wrist, finding a small hidden vein amongst the bruises and freckles and setting the IV there.

“Wow, thanks.”

“I did a stint at neonates, remember? Your veins aren’t so little compared to theirs.”

The redhead still has an awestruck look, but her grin suddenly turns into a grimace and she presses the hand with the IV against her chest. “Ugh, I’m getting palpitations.”

“Should I call your doctor?”

“No.” Her hand is caught in Anna’s before it reaches the call bell. “I always get them when you’re around.”

She feels a flush coming on and hastily reclaims her hand, darting her eyes downwards. Anna’s robe-gown has fallen a little open at the top, revealing a raised pink scar running linearly down the middle of her chest, and a few smaller and fainter ones at the sides of her neck.

Her staring doesn’t go unnoticed. “Should I be flattered that a cute doc is checking out my scar? Or are you checking out my–”

“Anna!”

The girl sombers up, tugging the flaps of the garment together. “I didn’t want you to see it. My ugliness.” Now she is the one who can’t look Elsa in the eye.

The shake of her head is gentle but firm. “I would never think that. A surgical scar is something beautiful. Every cut we make with the scalpel and blade is not to harm, but to heal.”

Anna’s fingers remain fisted in her lapels, but her glistening eyes glance up to meet Elsa’s, and her voice trembles ever so slightly as she speaks. “I spent my fifteenth birthday in this hospital. It started as a flu, and then I got breathless, really breathless. I was on a ventilator for a month. They said that my heart was failing, that the medications wouldn’t help for much longer…that I might have to go on a life support machine…that the only way I would survive is if I got a new heart.”

“I received my heart on the 27th of November, 2013. For six years I’ve lived with the guilt. That someone died so I could live.”

.

_“I’m so sorry Anna, I was going to make your favourite butternut squash soup and turkey sandwich, but they want me to pull a few extra hours at work.”_

_“Elsa, it’s fine! I can grab something for us on my way home.”_

_“We’re calling about your sister…she’s been in an accident.”_

_“Please, I can’t lose her–”_

_“I’m sorry, I wish there was more we could do.”_

_“Anna’s only fifteen! She isn’t in the donor registry–”_

_“That’s why we’re asking_ you _. Do you think it’s…what she would’ve wanted?”_

_“I was asked to pass you this. A letter from the girl who got her heart.”_

_There are a few smudged spots on the handwritten note. ‘I know there’s nothing I can say that will be enough. But I promise you this. I’ll live to the fullest and love to the fullest, I’ll do everything I can to be worthy of this heart.’_

.

Elsa doesn’t know how long she has been running, but somehow she’s ended up back here, in the place where lives are saved and lost every day. After what feel like hours of aimless wandering, she finds herself on the rooftop of the building, feeling the rain beating down on her frosty skin. Her face is slick with a wetness that tastes a little salty on her lips.

They say that the rain is a symbol of catharsis, of letting go. But her tears have always felt like salt on an open wound, a wound that’s never healed. Never been given a chance to. 

She lets her eyes fall shut, and when she opens them again, she discovers she’s not alone. Judging by the wet gown clinging to her skin, Anna must have been standing there a while before she noticed her.

She joins Elsa by the ledge. “It feels like it always rains hardest on the ones who deserve the sun.”

“How did you find me?”

A glimmer of a smile crosses Anna’s face. “I followed my heart.”

“Did you know–” She pauses, biting her lip, before parting them again. It’s an answer she needs to know, if only to figure out where she stands with Anna, and what they mean to each other. “–that I was the one you wrote that letter to?”

She hears Anna inhale a breath, releasing it slowly.

“All I know is that my heart was searching for someone, and that someone was you. That feeling, when we first met, it was like I’d known you before, in another time, another place. Like I’ve been loving you, all of my life, with all of my heart.”

Her touch is so familiar, tracing the tracks on Elsa’s cheeks. It only makes the tears fall harder. She lets Anna pull her in close, but she doesn’t have the strength to return the embrace, instead burying her head in the crook of her neck.

Anna is the first to pull away. “Do you want to listen to it?”

Still a quivering mess, she manages to give her a nod, allowing Anna to fit the tips of her stethoscope to her ears, holding the other end to the beating organ in her chest.

As the whole world fades to the sound of a heartbeat, she thinks that maybe _their both_ trying to tell her that it’ll be okay. That love can hurt, but also heal, if only she’ll let it.

“She was your sun, wasn’t she? The reason for your heartbeat. I took that away from you–”

“No, you didn’t.” She shakes her head adamantly. “You kept her alive.” 

“I’m not her, I won’t pretend to be.” Anna’s voice is raw, her eyes shining. “I know I can’t be your sun, but I can still stand with you in the rain.”

For the first time in forever, Elsa smiles through her tears. “How ‘bout we get out of this rain? _Together_. If you want to, I mean…it’s okay if you don’t, I just thought–”

Anna interrupts her with a soft chuckle. “I’d love to. And besides, I put a ring on it, didn’t I?”

**Author's Note:**

> If you’ve made it to the end, first of all, thank you. I doubt this will be read by many, but it’s nice to hope that it might resonate with one or two someones out there. And I do wonder if anyone caught the bits of foreshadowing leading up to the actual reveal? 
> 
> I really wanted to write something for the movie’s anniversary, by that I mean the first Frozen movie, which was released on 27th November 2013, if anyone got the reference!
> 
> Initially I was going to go with something much fluffier, where ‘pizza in the call room?’ would be Anna’s pick-up line and the profession of love would had gone something like this – ‘You give me palpitations (a love confession from a cardiac surgeon if she ever heard one); I love you too (the brain is a little more straightforward)’. But with the requisite dose of Elsa-angst. For a small teaser this was going to be the opening line – ‘Neurosurgery is a lot like life and love – it’s way too easy to leave someone more damaged than you started with.’  
> But in the end I just followed my heart, and this was what it wanted to write. 
> 
> It isn’t beta-ed, but I did ask a friend for honest feedback and she said that while the first half was a little confusing with the two ‘Anna’s, the ending was worth it for those with the patience to get there. I hope it was for others too. 
> 
> Elsa’s POV is something I’ve never dared to touch and I hope I got her portrayal right, and also the portrayal of how grief (even more than half a decade on) can be so profound and yet buried so deep, existing only in memories and regrets. Just like in the movie she hasn’t had the healthiest coping mechanism for the tragedies in her life. She’s already learnt one of life’s harshest lessons–how unpredictable, fragile, and unfair it can be, and that not enough stories get their happy ending. And she’s accepted it to an extent, and is still trying to do her best. Think Samuel Beckett’s ‘I can’t go on, I’ll go on’, because it’s what Anna would have wanted. At the same time, a heart that’s still grieving isn’t open to love, like a locked door that’s unable to let anyone in, until ‘Anna’ opens it again at the end. 
> 
> As for the Elsanna side of things, I guess it can be interpreted in many ways. Tbh I’ve always felt that there's an ambiguity to their relationship that isn’t just ‘angsty incest guilt’, and more of ‘I don’t know how to define us but all I know is I love you’. And that’s what I try to capture in this fic (and my other fics too). 
> 
> I better end this as it’s getting way long. If anyone has any thoughts or questions, please let me know in the comments! 


End file.
